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Scepticism still surrounds medical technology

By Sharmila Ganapathy-Wallace May 23, 2017

Medical sector players have upped their game to embrace digital tech before they get disrupted.

Engagement with patients is still very much in the hands of healthcare providers

FIVE years ago, if a patient in Malaysia had wanted to book appointments with a doctor using the mobile phone or even seek teleconsultation via the web or a mobile app, it would not have been possible because such services did not exist.

Today, however, there are medical technology companies such as GetDoc and BookDoc that connect patients and doctors via the web or a mobile app, telemedicine players such as Teleme and even medical concierge services are available today via Door2Door Doctor. And these are just a few of the medical technology (med tech) companies in Malaysia.

Technological innovation is happening in healthcare

As GetDoc Malaysia founder and CEO Jerry Hang says, the speed of digital innovation has caught up in many industries, such as healthcare. “Even though healthcare has always been slow to adopt innovative technologies, lagging behind other areas like telecommunication, transportation and retail, the speed of innovation is something that the medical industry has not been able to ignore.

“Driven by the likes of Uber, Grab and Airbnb making their mark as disruptive technologies, those in the medical sector have upped their game to embrace digital technologies before they get disrupted.”

He adds that medical technology has progressed much compared to five years ago due to a few reasons: public-private sector partnerships such as hackathons, medical devices bootcamps and healthcare innovation events, the increase in lifestyle-related diseases and an aging population, high mobile and internet penetration in Malaysia, the growth of medical tourism, changing patients’ awareness and education levels, as well as the rise of millennials who are actively looking to adopt modern, state-of-the-art medical devices and healthcare technologies.

Teleme CEO and co-founder Dr. Hoh Hon Bing (pic, above), concurs and in fact, feels that Malaysians are more receptive towards telemedicine, of which teleconsultation is part of.

“Patients SMS and WhatsApp their doctors, they have all been doing this for the past four or five years. We have overseas patients, and patients who are from other states. They just want to follow-up with the doctor or to seek consultation for the medications they are already taking.

“There are also patients from overseas who seek advice via teleconsultation before they fly to Malaysia for treatment and hence are able to plan their trip in advance. When they go back to their home country, their doctor in Malaysia is still available via teleconsultation.”

He adds that as recently as two years ago, although the technology was already available, the perception and trust towards telemedicine was not quite there.

“I feel that there’s has been a readiness that has scaled with the acceptance of e-commerce. The older doctors will never use this, people who don’t buy things online, use Skype or Netflix, will never be ready for it. But the millennials are different and more receptive.”

Healthcare professionals are unsure

While it is clear that medical technology in Malaysia has come a long way, healthcare professionals that Digital News Asia spoke to appeared somewhat unconvinced that medical technology is the holy grail of healthcare in Malaysia.

“I think one of the challenges is that we are lacking in IT. The second challenge is that medical care costs are escalating and unsustainable. And this brings into question three things: the affordability of medicine, availability of medicine especially to the rural people and accessibility as well. And I think ICT potentially can answer them to some extent. But this kind of thing is not matured yet. Med tech should think about virtual care as in what areas can be delivered besides linking patients to doctors.”

The age of patients does not appear to be a major issue. “Surprisingly we were worried that the people using med tech services may not understand them, but in fact most of the people who accept online contact with doctors are apparently above 55 years old. And that suggests that our worry that the elderly may not trust technology, may be wrong. But the elderly maybe in their late 60s and 70s may be an underserved group. So the med tech companies need to see if they can reach out to the elderly more, that’s the thing that is really outstanding.

“Another element not addressed is the element of trust. How much can we trust IT and the Internet- contact with patients from the security and confidentiality points of view? I think these are the questions that the med tech industry needs to address. How we can make these developments, secure as well as confidential?”

Malaysian Medical Association president Dr. John Chew (pic, right) agrees that healthcare technology is on the rise and therefore it is inevitable that med tech companies will play a big role in the delivery of healthcare in Malaysia.

“However, we have not reached the stage yet whereby such medical tech companies will have a significant impact on the way patients interact with doctors. Inter-generational factors are in play. The carers might be tech savvy and willing to pay but the patients are not. Old habits of using the neighbourhood clinics are still dominant,” he says.

Chew says that healthcare delivery is a personal matter between patients and doctors. “Hospitals and clinics are still easily accessible. Follow-ups are often done through the mobile phone. Communication is improved with the hand phone but it is within the traditional doctor/patient relationship,” he emphasises, adding that engagement with patients is still very much in the hands of healthcare providers.

Opportunities for collaboration exist

Yet others, while being realistic, see opportunities for collaboration between med tech companies and healthcare providers. When asked if med tech companies are truly making an impact on the way patients interact with doctors, Ramsay Sime Darby chief executive officer Bronte Kumm says: “By and large med tech companies have put in place appointment systems or the ability for patients to access appointments with doctors. So there is a simple way they are, but I think that in more complex ways and that is, accessing the doctors’ opinions, accessing relationship building exercises with doctors and accessing information, things are still slow.”

He adds: “And I know that med tech companies will say adoption by patients is slow, but I think at times, we (hospitals) should be responsible with organising our side and having a product available now and then work on educating our patients on the advantages of the information. I know at times we’re driven by revenue and utilisation, so med tech companies sit back and say: until there’s a million patients going to use the system, we won’t develop it.

“But I think the reverse should be true. I think hospitals should accept responsibility for paying the med tech companies to develop this product to the extent that they are delivered to the patients’ front door. And the next step should be teaching and educating our patients how to use it. So I think that the hospitals need to engage the med tech companies and lead the way to take the product to the patient. Because many people see the patient as a source of revenue, I don’t think for med tech companies patients are necessarily the source of revenue, I think the hospitals are.”

What are the gaps that exist that medical technology can help close? Kumm says that the gaps that exist at the moment are what med techs are delivering.

“What I think needs to happen largely sits in the space of the hospital, which is distilling, analysing and simplifying its information. Patients are becoming increasingly sophisticated, many are already. But the challenge is to get that information from the hospital (all aspects) such as appointment time, doctors’ opinions, direct engagement with the doctors -- a system by the way patients can navigate the healthcare system and the clinical information.”

The gap, he adds, is a sensible platform for that to occur. “Many of the electronic medical records and information technology platforms will say they have the capability. But certainly, in Asia at the moment, and in many other countries such as France and the UK, I think the sophistication of the platform and the quality of the information that sits on that platform and its mobility, still have a long way to go.”

Challenges faced by med tech players

GetDoc’s Hang acknowledges that the challenge of embracing new technology in the medical field has always been the scepticism associated with it.

“Although scepticism to new technology in medical can be a huge disadvantage, scepticism also protects us from unproven technologies. As a result, this proves to be a huge opportunity for those who know the medical industry well and are able to provide solutions based on insights gathered from various stakeholders. The speed of innovation from these individuals or groups can also be enhanced with smart partnerships with those outside the medical industry,” he says.

Additionally, Hang says that med tech companies have difficulty addressing market segments with very different needs. “Many hospitals, and especially the larger urban ones, tend to serve both the premium and broader, more value-focused segments, but most med tech companies have focused solely on the premium segment.”

According to Hang, med tech companies also struggle with a patchwork of regulatory regimes and reimbursement systems, each with different capacities, levels of sophistication, and policy priorities. “Adding to the burden, the landscape is changing swiftly as governments work to improve access to healthcare. To name a few challenges: there is fragmentation, lack of support from the local industry, capacity, and reimbursement systems.”

Hang believes that the med tech ecosystem in Malaysia should be cultivated not only from the startup scene but also from hospitals, distributors, pharmaceutical companies and the Ministry of Health.

“This will not only provide a good platform for innovation to further improve Malaysian healthcare but also healthcare within the Asia Pacific region,” he concludes.